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If you have tried diet and exercise but have stubborn areas of fat, liposuction may help change your body shape.
Liposuction isn't safe for everyone – you face greater risks if you are over 45, are obese, or have a serious illness.
Liposuction is not a weight loss surgery and is unlikely to improve the health effects of being overweight.
Liposuction is incredibly popular in the US and it's only getting bigger. In 2018, 258,000 people went in for the procedure, 5% more than the year before.
People often think of liposuction as a quick and easy procedure, but like any surgery, it shouldn't be taken lightly. Though it's relatively safe, liposuction carries risks, especially for people with certain health issues.
If you are looking to lose weight, diet and exercise are your best. Liposuction is a way to reduce stubborn fat in certain areas like the abdomen, upper arms, and thighs. Here we review criteria and risk factors you should consider when deciding whether or not to get liposuction.
You need to meet certain criteria to get liposuction
Before you get liposuction, your doctor will decide if you are a good candidate for the surgery based on factors including your weight, skin quality, and overall health.
"Liposuction candidates need to be relatively healthy and without any serious medical conditions," says Marco Pelosi III, MD, a cosmetic surgeon, and board-certified gynecologist.
People who are pregnant or with severe heart problems or blood-clotting disorders should not get liposuction, as they may be at risk for dangerous, life-threatening complications like excessive blood loss.
Beyond that, the following factors can increase your risk of complications from liposuction::
Anyone over 18 can get liposuction, but people over 45 may face a slightly higher risk of complications such as hematoma (swelling of blood outside a blood vessel), infection, and venous thromboembolism (blood clot in a deep vein, like in the pelvis, lower leg, or thigh). For one large study, published in the Aesthetic Surgery Journal in 2017, of more than 31,000 liposuction procedures, 2.6% of people who suffered from complications were over the age of 45 compared to 2.3% who were 45 years or younger.
People with higher BMI are more likely to face complications like blood clots after surgery. Experts recommend that you should be within 30% percent of your ideal weight before getting liposuction. So, for example, if a healthy body weight for you is 150 pounds you should weigh no more than 195 pounds.
Chronic smokers are at a higher risk of developing a serious type of infection called skin necrosis after liposuction. If it's not treated immediately, skin necrosis can be lethal. And, in fact, an estimated 30% of people who develop some form of skin necrosis — not necessarily from liposuction — die, either because they didn't seek treatment soon enough or they were older or had other medical conditions. That's why surgeons recommend smokers cease smoking at least 3 weeks prior to getting liposuction.
In addition, surgeons recommend getting liposuction in areas where your skin has elasticity. People who get liposuction in areas where the skin is not very elastic and already loose may find that their skin appears even looser after removing fat from underneath it.
Though liposuction is used to remove extra fat, you won't get good results if you are very obese, Pelosi says. This is because you can end up with, what experts call contour irregularities, or basically an uneven body shape.
You can only get liposuction on some body parts
The most common areas to get liposuction are the torso, arms and legs, breasts, buttocks, and around your chin or jawline, Pelosi says.
These are all areas of subcutaneous fat, the jiggly fat that lies just under your skin and above your muscles and internal organs.
The other type of fat is visceral fat, which surrounds your organs and creates the large "beer belly" shape, Pelosi says. This type of fat can't be removed by liposuction, but you can reduce it with diet and exercise.
Liposuction is not a weight-loss surgery
Though liposuction removes fat, it isn't a good solution for people who need to lose a significant amount of body weight. "Lipo is not weight loss surgery at all. You might lose a few pounds, but only in the areas that are treated," Pelosi says.
In fact, the American Society of Plastic Surgeons warns about the risks of performing "high volume liposuction" of over 5 liters of fat, or about 10 pounds worth. Some doctors completely avoid going over this limit for safety reasons.
For comparison, for surgeries like gastric bypass, which reduces the size of your stomach, obese patients can lose almost a third of their body weight. That can equate to tens to over 100 pounds.
Unlike weight loss surgery, liposuction won't make you healthier or reverse any medical problems, Pelosi says. Because having excess fat increases your risk of heart disease, some researchers have looked into whether getting liposuction can boost heart health as well as help improve blood sugar in diabetics.
A study, published in 2018 in the journal Obesity, found that even after getting high volume liposuction, patients saw no improvements in heart risk factors like cholesterol and blood pressure. Which makes sense since liposuction only removes subcutaneous fat but not visceral fat, which is the type of fat linked to heart disease. However, a 2014 study and a 2017 review found that liposuction may improve fasting insulin levels, an indicator of diabetes.
More research is needed on how liposuction affects health, but for now, it's a good body contouring technique for the right patient.
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